Unknown cause of sudden infant death

Unknown cause of sudden infant death

12.07.2011

All parents are worried that their newborn baby might die from sudden infant death. So far, research has failed to explain how the unexpected demise of infants occurs. But parents can reduce the risk if they pay attention to certain factors.

Sudden infant death Most common cause of death
Deaths due to sudden infant death syndrome have been steadily decreasing for several years. That's good news for now. Today, however, around 250 babies still die from sudden infant deaths each year. Just over 20 years ago there were still 1300 children per year. Accordingly, scientific studies have significantly reduced the mortality rate. Nevertheless, sudden death is still the leading cause of death in babies. 80 percent of deaths occur in the first six months after birth. For comparison, only five percent of child death can be explained after the first year of life.

Despite the successes achieved, medicine still can not give a clear explanation why suddenly an infant dies. Parents and doctors are almost powerless exposed to this terrible phenomenon. Because there are no recognizable early indications or symptoms that could indicate a death event. Only on risks can parents pay attention and try to switch them off as possible. And yet the danger is not banished, as Prof. Dr. med. Gerhard Jorch from the University Hospital Magdeburg explained. Because the „vast majority of cases of sudden infant death syndrome is such that the parents did everything right“. And yet the child died then. Jorch has been one of the leading scientists in the research field for years „sudden infant death“. For example, in 2004 the researcher received the Meinhard von Pfaundler Prevention Prize from the Foundation for Child Health due to his successful work.

Congenital risk factors suspected
Above all, many parents want to know if there are innate factors that increase the risk. Unfortunately, hardly any of them are known. What you know, you often only on the basis of statistical data. According to this, boys are slightly more affected than girls at 60 percent. In addition, preemies and babies of very young mothers have a slightly higher risk. There is also an increased risk if sudden infant death has ever happened in a family. Some researchers have already discovered genes that are responsible for the disturbed respiratory reflexes and lack of oxygen, Jorch explained. In the future, the first research could already start to substantiate the still very theoretical substructure. Because at the moment „these aspects have a purely theoretical meaning.“ said the expert opposite „Focus Online“. Theoretically for that „Sudden Infant Death Syndrome (SIDS)“ - as the sudden infant death is called in the medical circles - are also most other explanatory models. A majority of researchers believe that inadequate oxygen supply is triggered by disrupted blood flow to the brainstem. Damage to the artery in the brain can be seen in the ultrasound. But such an explanation pattern does not cover the entire range of all factors, as Jorch reminds us. „When an infant dies unexpectedly and without apparent cause, several factors are always miserable.“ It would therefore bring nothing one of the possible causes time-consuming and consuming to explore.

Prevention in practice more important than research into risk factors
The pediatrician advocates rather for a further development of the prevention, in order to be able to protect the child optimally in the practice. A positive preventive approach is the so-called „Pacifier theory“. Because the pacifier has proven to be a practical Vorsorgeschutz. This is especially true for children who are not breast-fed, explains the doctor. It is unclear why children are less likely to suffer a sudden death if they pacify regularly. It is likely that babies with a pacifier usually sleep in the back and not in the prone position. „In supine position the handling of the pacifier is easy for parents and children, not on the stomach.“ Midwives often tell mothers that their children should not sleep in prone position. That's right in principle. Nevertheless, children should definitely learn to lie in prone position. Because the eyes of the parents are not always focused on the children. Therefore, the prone position should be rehearsed while awake. „Parents should train with the awake child. There have been SIDS cases, when a baby turned on his stomach for the first time in his life and lay helpless on his face.“

Child vaccinations may increase the risk
Above all critics accuse the child protection vaccinations of complicity in the infant deaths. However, this possible connection has not been proven to this day. „There is no direct cause-and-effect effect, as recent studies have shown.“ A vaccination does not want to question the researchers. But he can well imagine that fever as a result of vaccination can act as a trigger. Therefore pediatricians should inform parents that fever can occur in the next few days or weeks after vaccination. The parents should then keep a particularly close eye on their child, so the pediatrician Jorch.

Biggest risk around the 100th day of life
In the case of the SIDS, the children choke in their sleep. The babies do not wake up when they have to cough, they do not wake up when they have to spit. And they do not wake up when they can not breathe. The actually automated reflex to unconscious breathing suddenly sets in motion. The babies just stop breathing. Often it came to the disaster, because they slept on the stomach. Most often, sudden death occurs between the ages of 8 and 16 weeks. Experts suggest that many children accidentally put their heads under blankets or pillows. From this situation, the child can no longer free itself and smothered. The climax reaches the risk level around the 100th day of life. This is precisely the point in time when the baby turns the pure reflex movements into voluntary movements, as the researcher explains. The babies can then grab the cuddly blanket, but this will not let go afterwards. Due to this situation the cot becomes a danger to life. For this reason, cuddly animals and pillows should have nothing to look for in the cot. The social pedagogue Dipl. Gritli Bertram therefore recommends that all parents sleep their baby without a pillow in a children's sleeping bag. „The baby should be stored constantly on the back. Only when the child is awake, it should also be placed once in the prone position. The parents should not let their child out of sight“, said the teacher. Just a few decades ago, the directive was that the children should always be placed on their stomach. The forms allegedly form the back of the head and promote the well-being of the child. However, in the 1980s, GDR scientists found out that abdominal sleep statistically increases the infant mortality rate. Since then, the directive was in the former GDR to store children only on their backs. In fact, the mortality rate dropped afterwards. In Germany, this realization prevailed only in the 90s. In addition, it was now known that sleeping bags also reduce the risk because they can not be pulled over the head. Breastfeeding should also have a positive effect on breast milk because it strengthens the immune system of the child and reduces the risk of fever attacks. (Sb)

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Picture: Manuel Bendig